Gallbladder Mysteries: A Diagnostic Dilemma in Mirizzi Syndrome With Acalculous Presentation

Mirizzi syndrome (MS) is an uncommon condition caused by chronic gallbladder stones, leading to external compression and obstruction of the common hepatic duct. This report details an unusual MS case in a 65 year-old man who experienced right upper abdominal pain, jaundice, fever, and nausea. Diagnostic tests, such as ultrasound and CT scan, indicated acute acalculous cholecystitis resembling MS. However, a magnetic resonance cholangiopancreatography (MRCP) confirmed no gallstones in the biliary system. The patient's laparoscopic cholecystectomy was successful, with tissue analysis revealing intense gallbladder inflammation and epithelial necrosis but no gallstones. This case emphasizes the diagnostic complexities of atypical MS presentations and the need for comprehensive diagnostic methods, including MRCP. Additionally, the report advocates for standardized terminology in medical literature to ensure clear communication among medical professionals.